LYMPH FLOW AND PROTEIN IN THE NORMAL MALE LEG DURING LYING, GETTING UP, AND WALKING

Abstract

Leg lymph protein concentration and output,
lymph/serum total protein and albumin ratio and
lymph flow/concentration relationship were studied
in four normal men with limbs immobilized in the
horizontal position over two 24-hour periods,
followed by a day in the upright position. A high
concentration of total protein and albumin and the
L/S ratio and a high protein output were found with
immobilization. Assumption of the upright position
after 24 hours of horizontal rest was followed by a
high lymph flow with high protein concentration.
This effect suggested the accumulation of large
amounts of protein in the lymph space during the
preceding rest period. The failure of lymph protein
concentration to fall and an insignificant decrease in
L/S total protein ratio render it unlikely that a
sudden rise in capillary filtration occurred. Moreover,
an essentially unchanging total protein and albumin
L/S ratio is evidence against a sudden increase in
capillary permeability. Moreover, a continuous
decrease in lymph protein concentration during the
day in the upright position probably occurs when
" new" capillary filtrate replaces the proteins
accumulated in the lymph space during the periods
in the horizontal position. There is no diurnal
rhythm in lymph protein concentration. The fast
and large lymph flow that develops after assumption
of the upright position and the continuous protein
wash-out with ambulation are protective safety
factors against edema formation in the leg.